Posted by greenhornet on December 27, 2005, at 7:30:06
In reply to medication-induced apathy, posted by med_empowered on December 22, 2005, at 23:24:54
I agree whole-heartedly with med-empowered.
..I was put on Seroquel due to a "psychotic reaction" to another med/med combo. (Actually I started on Zyprexa, but after gaining 50lbs in two months, I begged for the change) After a year I began to taper off the Seroquel and my experience is that, even with what are supposed to be "sub-clinical" doses, metabolism is effected. I took 25mgm for about six months then went to 12.5 for another six ("for sleep").Within days of stopping to Seroquel completely I began to lose weight, and my appetite was more managable (ie no carb cravings).
I have been off the Seroquel for nearly a year, and in that time returned to my weight of four years ago prior to being put on the atypical antipsychotics.
Lest you doubt all of this, last month I tried taking the 12.5 mgm because I was haveing some sleep difficulties; and after ONE WEEK I had gained seven pounds! I know it isn't "supposed to happen " at that low a dose, but arent there unknowns with all meds?!
------------------------------------------> It seems like lots of psychiatric meds induce apathy. SSRIs, antipsychotics, benzos--you name it, one of the main effects is a sort of sedated apathy.
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> Seroquel's apathetic effects are, I imagine, caused both by its antipsychotic action (which I would think would be minimal at 25mgs/day) and by its pronounced sedation.
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> The first choice for severe anxiety would probably be a benzo, for me at least. Ativan might be cleaner than Klonopin; it tends to just cause sedation and/or kill of anxiety, while Klonopin also has effects on mood. If you keep the dose low, and use it strictly as needed, then you could probably minimize apathy.
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> Effexor could also be causing some apathy for you..I know that SSRIs tend to make me much more apathetic, and I've noticed it in my friends as well.
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> I'm kind of concerned that so many people are on antipsychotics for anxiety. Antipsychotics can help with anxiety--this was one of their primary uses from the 50s-70s, before concerns about TD,NMS, and other issues became a big deal-- but given the cost and side effects, it would seem most prudent to use them **only** in psychosis or cases of unresponsive mood disorders.
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> I think you might want to try a benzo, such as ativan. BuSpar is an option. Its kind of antipsychotic-ish, and higher doses make me feel strangely "unnerved" (low-grade akathisia?) and somewhat dysphoric but...lower doses I imagine could be helpful without causing too many problems.
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> Some people swear by Lyrica, the super-Neurontin that just got released. However, given Neurontin's shady history in the psychiatric realm, I think it might be a good idea to put off using it until it has a good track record (assuming this happens).
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poster:greenhornet
thread:591095
URL: http://www.dr-bob.org/babble/20051221/msgs/592387.html